Your Name (required)

Your Email (required)

Your Phone Number (optional but highly recommended)

Date Requested (please indicate if you are flexible and open to alternate dates)

Entertainment Start Time Requested (please indicate if you are flexible with start time)

Entertainment End Time Requested (please indicate if you are flexible with end time)

Length of Entertainment (please indicate if you are flexible with length of performance)

Type of Event or Venue
 Library School Cub Scouts Summer Camp Preschool/Daycare Festival Block Party Grand Opening Trade Show Corporate Event Other (not on this list)

Comments
Please provide as many details as you can about your event. The more information you provide, the more Jason Kollum can understand your event. This will help him determine the best type of entertainment possible at the best price.

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